Individual
LARRY VERN SMALLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4526 FEDERAL AVE, EVERETT, WA 98203-2132
(425) 349-6200
Mailing address
PO BOX 25533, FEDERAL WAY, WA 98093-2533
(253) 886-7762
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
CM60901639
WA
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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